Organization
WOOD RIVER NH LLC
Active
Other names
Foxes Grove Supporting Living
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MASON (PRESIDENT)
(813) 347-7425
Entity
Organization
Contact information
Practice address
395 E EDWARDSVILLE RD, WOOD RIVER, IL 62095-1600
(618) 259-0851
Mailing address
395 E EDWARDSVILLE RD, WOOD RIVER, IL 62095-1600
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/10/2016
Last updated
06/25/2021
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